Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 200850132NP | OR |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP60422978 | WA |
NPI | 1023269768 |
---|---|
Provider Name | Katie Kern |
First Address | Renton, WA 98055-5933 |
Second Address | Renton, WA 98057-3227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2008 |
Last Update Date | 16/03/2020 |